与经导管盆腔动脉栓塞术治疗难治性产后出血失败相关的因素。
The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage.
作者信息
Yamasaki Yui, Morita Hiroki, Miyahara Yoshiya, Ebina Yasuhiko, Okada Takuya, Yamaguchi Masato, Yamada Hideto
出版信息
J Perinat Med. 2014 May;42(3):359-62. doi: 10.1515/jpm-2013-0242.
OBJECTIVE
The transcatheter pelvic arterial embolization (TAE) is effective for postpartum hemorrhage (PPH). There has been a little information about the factors for ineffectiveness of TAE. The aim of this study was to determine factors associated with TAE failure for PPH.
STUDY DESIGN
Fifty-five women who underwent TAE for intractable PPH were included. Clinical factors involving age, history of pregnancy, gestational weeks of delivery, mode of delivery, causes of PPH, complete blood count, blood loss volume, transfusion amount, shock index and disseminated intravascular coagulation (DIC) score were compared between TAE success group (n=48) and TAE failure group (n=7).
RESULTS
The uni- and multi-variate analyses revealed that advanced maternal age (OR 1.46, 95% CI 1.12-2.18) and retained placenta as a cause of PPH (15.48, 2.04-198.12) were found to be significant factors for TAE failure.
CONCLUSION
The advanced age and retained placenta were independent factors associated with TAE failure for intractable PPH.
目的
经导管盆腔动脉栓塞术（TAE）对产后出血（PPH）有效。关于TAE无效的因素的信息较少。本研究的目的是确定与PPH的TAE失败相关的因素。
研究设计
纳入了55例行TAE治疗难治性PPH的女性。比较TAE成功组（n = 48）和TAE失败组（n = 7）之间的临床因素，包括年龄、妊娠史、分娩孕周、分娩方式、PPH的原因、全血细胞计数、失血量、输血量、休克指数和弥散性血管内凝血（DIC）评分。
结果
单因素和多因素分析显示，高龄产妇（OR 1.46，95% CI 1.12 - 2.18）和胎盘残留作为PPH的原因（15.48，2.04 - 198.12）是TAE失败的重要因素。
结论
高龄和胎盘残留是与难治性PPH的TAE失败相关的独立因素。
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